Therapeutic Efficacy and Safety of Multi-Modal Ayurvedic Protocols in the Management of Garbhashayagata Arbuda (Uterine Fibroid): A Systematic Review
Abstract
Background: Uterine fibroids are the most common benign tumors of the female reproductive system and are associated with heavy menstrual bleeding, pelvic pain, dysmenorrhea, infertility, and reduced quality of life. Ayurveda offers a conservative approach to management through Shodhana and Shamana therapies; however, the available clinical evidence requires systematic evaluation. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, AYUSH Research Portal, DHARA, and Google Scholar. Clinical studies evaluating Ayurvedic interventions for uterine fibroids were screened according to predefined eligibility criteria. Data on study characteristics, interventions, outcomes, safety, and risk of bias were extracted and qualitatively synthesized. Risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Results: Seven clinical studies published between 2014 and 2026 were included. The interventions comprised Panchakarma procedures (Vamana, Virechana, and Uttara Basti) and classical Ayurvedic formulations. Most studies demonstrated significant reductions in fibroid size, menstrual bleeding, pelvic pain, and symptom severity. Combined Shodhana and Shamana therapies generally produced superior outcomes compared with oral therapy alone. No serious adverse drug reactions were reported. The overall risk of bias ranged from some concerns to moderate. Conclusion: Ayurvedic interventions appear to be safe and beneficial in reducing fibroid size and improving clinical symptoms. However, larger, well-designed randomized controlled trials with standardized treatment protocols and longer follow-up are required to strengthen the current evidence.
Keywords: Uterine fibroid, Garbhashaya Granthi, Panchakarma, Uttara Basti, Systematic review.
Keywords:
Uterine fibroid, Garbhashaya Granthi, Panchakarma, Uttara Basti, Systematic reviewDOI
https://doi.org/10.22270/jddt.v16i9.7952References
1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma. Am J Obstet Gynecol. 2003;188(1):100-7. https://doi.org/10.1067/mob.2003.99 PMid:12548202
2. Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids. Int J Womens Health. 2012;4:95-114.
3. Pandey D, Sehgal K, Saxena A, Hebbar S, Nambiar J, Bhat RG. An audit of indications, complications, and justification of hysterectomy. J Midlife Health. 2014;5(2):93-6. https://doi.org/10.1155/2014/279273 PMid:25763395 PMCid:PMC4334049
4. Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization vs surgery for fibroids. Cochrane Database Syst Rev. 2014;(12):CD005073. https://doi.org/10.1002/14651858.CD005073.pub4
5. Sharma R, et al. A comparative randomized clinical study on Vamana Karma and Uttara Basti in the management of uterine fibroid. International Journal of Innovative Research in Technology (IJIRT). 2026.
6. Singh R, Gupta S, Singh AK, et al. A comparative pilot study on the treatment of uterine fibroids using traditional medicines and intrauterine enema therapy. Journal of Ayurveda and Integrative Medicine. 2025;16(1):100987. https://doi.org/10.7759/cureus.91387
7. Shindhe P, Rachana HV. A clinical study in the management of Garbhashaya Granthi with Sarjadi Lepa with special reference to fibroid uterus. International Journal of Research in Ayurveda and Pharmacy. 2024;15(1):61-68. doi:10.7897/2277-4343.15114. https://doi.org/10.7897/2277-4343.15114
8. Karunagoda K, et al. Management of uterine fibroids with Ayurveda: A randomized single-blind clinical trial. Journal of Ayurveda and Integrative Medicine. 2021;12(4):706-714. https://doi.org/10.1155/2021/4325502 PMid:34257678 PMCid:PMC8260316
9. Rajput S, et al. Comparative clinical study of Virechana followed by Triphaladi Yoga and Uttarbasti in the management of uterine fibroid (Garbhashaya Granthi). International Journal of Research in Ayurveda and Pharmacy. 2020;11(6):95-101
10. Akhila VG, Asha ST. Effect of Nimbadi Kashayam and Kanchanara Guggulu in uterine fibroids. International Journal of Applied Ayurved Research. 2020;4(9):995-999.
11. Dhiman KS, et al. Ayurvedic management of uterine fibroid: A case series. AYU. 2014;35(4):459-463. https://doi.org/10.4103/0974-8520.153750 PMid:26664240 PMCid:PMC4649577
12. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://doi.org/10.1136/bmj.i4919 PMid:27733354
13. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366: l4898. https://doi.org/10.1136/bmj.l4898 PMid:31462531
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